WHO concerned about MERS spread during Ramadan pilgrimage; Red tape hinders research

While no travel restrictions or health warnings have been issued against countries affected by the MERS outbreak, WHO has expressed concerns over the spread of infection. Hundreds of thousands of Muslim pilgrims will travel to Mecca during the holy month of Ramadan.

Daily updates by the Centre for Disease Control and Prevention (CDC), and the World Health Organisation (WHO) put the mortality rate for MERS at 56% worldwide, and 60% in Saudi Arabia. While the outbreak hasn’t occurred on a scale as large as the SARS outbreak of 2003 that has claimed 800 lives so far, it’s mortality rate is substantially higher than SARS’s 8%. Both diseases are genetically related as the virus that causes them comes from the same coronavirus family.

The number of MERS cases and deaths from April 2012 until present stand as follows (these figures are as of June 21, 2013):

The MERS virus, first appearing in a 60-year-old male patient in Saudi Arabia in April 2012, has so far claimed the lives of 38 people worldwide. The outbreak is concentrated in the Middle East, with 53 of the 68 reported cases of infection being in Saudi Arabia alone.

A recent study published in the New England Journal of Medicine has found that the novel coronavirus, now commonly known as Middle East Respiratory Syndrome (MERS) is a ‘serious risk’ in hospital environments. The international investigative team behind the study, encompassing doctors and researchers from US, Canada, and Saudi Arabia, were invited by Saudi officials in May to analyse the outbreak of the deadly virus in Saudi hospitals.

The NEJM study was carried out by the same group of doctors and investigators that investigated the deadly SARS outbreak in Toronto in 2003. Dr Trish Perl, a senior epidemiologist at Johns Hopkins, and a member of the team said that their investigation “showed some surprising similarities between MERS and SARS”, adding that “Both are very deadly viruses and easily transferred between people, and even between healthcare facilities”.

The team compared the MERS cluster in Saudi Arabia to the previously investigated SARS outbreak in Toronto for their study.

While unable to identify exactly why MERS is such a serious threat in an hospital environment, researchers have hypothesised this occurs as the reduced immune systems of patients in wards makes them highly susceptible to viruses being inadvertently carried from person to person by health workers caring for multiple patients.

Scientific red tape impedes research for cure

The virus has an average incubation period of 10 days, similar to that of SARS, after which it presents itself in the infected patient as a fever, cough, upper respiratory tract infection, vomiting, and diarrhoea. As the disease progresses, pneumonia, respiratory failure, renal failure and multiple organ dysfunction precede imminent death.

Doctors around the world are worried about the lack of substantial treatment for MERS-CoV. Current treatments include anti-virals ribavirin and interferon-alpha 2b to stop the virus from copying itself and spreading. Patients are also intubated and treated with “continuous positive airway pressure and nebulised medications”, according to the study.

However, efforts at finding a cure for MERS have been slow, with research being stalled by scientific red tape. Saudi officials have recently accused a laboratory at the Netherlands’ Eramus University of impeding efforts to develop a treatment for the deadly coronavirus that continues to take lives. Controversy has stemmed from the initial MERS-CoV sample sent to virologist Ron Fouchier at the Erasmus Medical Center in Rotterdam by the Saudi microbiologist Dr Ali Mohamed Zaki.

The country’s Deputy Health Minister, Ziad Memish recently said “We are still struggling with diagnostics and the reason is that the virus was patented by scientists and is not allowed to be used for investigations by other scientists. Samples … were shipped outside of the country without the knowledge or permission of the ministry of health, and I cannot believe that any country on this planet would allow this to happen.”
Fouchier has denied these allegations.
More details on this stand-off can be found here.

Qatar prepared?

So far, Qatar has responded to the situation by setting up 18 rooms at the Hamad Medical Corporation for treatment of any symptomatic patients. The Supreme Council of Health (SCH) also recently launched a website in an effort to better educate the public about MERS-CoV. The site covers basic prevention methods. The SCH also set up a hotline (6674 – 0951) for any other concerns about the virus.

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Comments

I hope it’s not true that the virus was patented by scientists and is not allowed to be used for investigations by other scientists because that is utterly irresponsible. Nevertheless, pilgrims must be extra careful of their health and ensure that they are always in as perfect a condition as possible.